Disasters continue to occur around the world and emerging threats may continue to influence the communities around the world. To ensure communities are prepared to response to these threats, healthcare systems must engage and plan together with their community. The literature review revealed that emergency preparedness could vary among healthcare systems that are equally equipped to handle a crisis in terms of resources; what the literature did not explain was which factors created such variations. The purpose of this study was to explore how and why healthcare systems, in the State of Nevada, have experienced successful outcomes with their emergency preparedness planning compare to other healthcare systems within the United States. The study's results are intended to help other healthcare professional understand the commitment, experience, and requirements when developing and maintaining a sustainable emergency preparedness program. This study was a qualitative case study and used an explanatory case study approach. Three themes emerged from this study. The first theme were the qualification, experience, education, and struggles of healthcare emergency preparedness program managers. The second theme was the preparedness of the emergency preparedness program managers and their healthcare systems' emergency response program. The third them was the healthcare emergency response operations. The study also highlighted why an all hazards approach to emergency is the best approach for healthcare systems and how community engagement helps healthcare systems mitigate some of the limitations identified. The study centered on the perceptions, experiences of participants' assigned these duties, and the finding may help other healthcare emergency preparedness program managers enhance their programs and received better results.
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